TY - JOUR T1 - Valsartan is more effective than placebo in reducing the incidence of diabetes in people with impaired glucose tolerance and cardiovascular disease or risk factors but has no effect on cardiovascular outcomes JF - Evidence Based Medicine JO - Evid Based Med SP - 122 LP - 123 DO - 10.1136/ebm1412 VL - 16 IS - 4 AU - Yves Lacourcière AU - Luc Poirier Y1 - 2011/08/01 UR - http://ebm.bmj.com/content/16/4/122.abstract N2 - Commentary on: McMurray JJ, Holman RR, Haffner SM, et al.; NAVIGATOR Study Group. Effect of valsartan on the incidence of diabetes and cardiovascular events. N Engl J Med 2010;362:1477–90OpenUrlCrossRefPubMed. Impaired glucose tolerance, which represents an intermediate stage before the onset of diabetes, is associated with an increased risk of cardiovascular diseases. Moreover, the concomitant presence of confirmed cardiovascular disease or cardiovascular risk factors in glucose-intolerant patients significantly augments their risk of cardiovascular events. Among the different treatment strategies used in high-risk patients, blockade of the renin-angiotensin system (RAS) has been shown to decrease the onset of new diabetes as well as the incidence of cardiovascular events. Therefore, the NAVIGATOR study was designed to evaluate the efficacy of blocking the RAS on the incidence of predetermined cardiovascular events such as myocardial infarction and stroke and on the prevalence of new diabetes. This was a double-blind, randomised, placebo-controlled, clinical trial (ClinicalTrials.gov … ER -